Provider Demographics
NPI:1972146736
Name:SORTAIS, JULIE ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:SORTAIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 N HARPER AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3753
Mailing Address - Country:US
Mailing Address - Phone:714-394-0611
Mailing Address - Fax:
Practice Address - Street 1:4700 W SUNSET BLVD FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6070
Practice Address - Country:US
Practice Address - Phone:323-783-7351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW267611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical